Tuberc Respir Dis.  2013 Aug;75(2):67-70.

Minute Pulmonary Meningothelial-Like Nodules Simulating Hematogenous Lung Metastasis: A Case Report

• Lee SK
• Kim GJ
• Kim YJ
• Leem AY
• Hwang ED
• Kim SK
• Chang J
• Kang YA
• Kim SY

Abstract

A 52-year-old man was referred to our clinic for an 11.3 mm nodule in the left lower lobe that was discovered on a chest computed tomography (CT) scan. Eleven small nodules were subsequently found in both lungs. Initially, we performed a transthoracic needle aspiration using CT scan guidance. The pathologic report showed a few clusters of atypical cells that were suspicious for malignancy. The positron emission tomography images revealed multiple lung nodules scattered throughout both lungs. The largest nodule (11.3 mm) in the left lower lobe did not have any discernible fludeoxyglucose uptake. For pathologic confirmation, we consulted a thoracic surgeon to perform the video-assisted thoracoscopic surgery. The final diagnosis was minute pulmonary meningothelial-like nodules (MPMNs). MPMNs are benign in nature, and only a few cases require treatment. However, when clinicians are suspicious of potential malignancy, a pathological correlation is essential, even if the final diagnosis is MPMNs.

Keyword

Lung Neoplasms; Neoplasm Metastasis; Immunohistochemistry

MeSH Terms

Immunohistochemistry
Lung
Lung Neoplasms
Needles
Neoplasm Metastasis
Positron-Emission Tomography
Thoracic Surgery, Video-Assisted
Thorax

Figure

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  Figure 1 Chest computed tomography showing an 11.3 mm well-defined nodule in the left lower lobe without any gross signs of calcification, and multiple small nodules of various sizes in both lungs.

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  Figure 2 Positron emission tomography showing the largest nodule (11.3 mm) in the left lower lobe without any discernible fluorodeoxyglucose uptake.

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  Figure 3 Surgical lung biopsy specimen showing the typical histological features of minute pulmonary meningothelial-like nodules. An interstitial proliferation of cytologically bland oval to blunted spindle cells is shown. The cells enveloped the small blood vessels, and seemed to form whorls with dispersed nuclear chromatin (H&E stain, ×200).

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